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Biomedical subjects

Ricardo Izurieta

Publications and source records attributed to Ricardo Izurieta.

3 recordsLinked to original sources

Association between intestinal parasitic infections and type of sanitation system in rural El Salvador.

OBJECTIVE: To identify demographic, behavioural and environmental determinants of intestinal parasitic infection, evaluate the impact of a variety of dry sanitation systems on intestinal parasitic infection, and evaluate the safety of using stored biosolids in agriculture in order to guide future sanitation interventions in rural areas of El Salvador. METHODS: Interviews were conducted with 109 households in eight communities where double-vaulted and solar urine-diverting desiccating latrines, pit latrines or no latrines were used. Faecal samples from 499 individuals were tested for enteric helminths and protozoa. RESULTS: Users of solar desiccating latrines had the lowest prevalence of enteric parasite infection. Double-vault, urine-diverting desiccating latrines effectively reduced the transmission of some pathogens, but may not achieve the conditions sufficient for the complete destruction of the more environmentally persistent pathogens, Ascaris lumbricoides and Trichuris trichiura. Contact with inadequately treated latrine biosolids was associated with an increased risk of Ascaris infection. CONCLUSIONS: Solar latrines were associated with the overall lowest prevalence of enteric parasitic infections. Members of households where latrine biosolids were used in agriculture had a higher prevalence of infection than those where biosolids were buried. We therefore recommend the promotion of solar latrines in rural areas of El Salvador over other dry sanitation systems, and recommend that stored biosolids not be used in agriculture.

Adolescent↗

Pramipexole in the management of restless legs syndrome: an extended study.

STUDY OBJECTIVES: To determine whether pramipexole used over an extended time for restless legs syndrome (RLS) remains effective; whether the dose of the drug needs to be increased; whether augmentation develops; and whether side effects, especially sleepiness, are prominent. DESIGN: Retrospective review of the records of consecutive patients treated with pramipexole for RLS. SETTING: Sleep disorders center in an academic hospital. PATIENTS: 60 consecutive patients treated with pramipexole for RLS. INTERVENTIONS: N/A. MEASUREMENTS AND RESULTS: Pramipexole was completely effective in controlling RLS in 67%, partially effective in 27%, and ineffective in 7% of patients. Eleven patients (18%) discontinued pramipexole after less than 4 months; the remainder were followed for a mean of 27.2 months, during which only 4 others stopped the drug. The median daily dose increased from 0.38 mg after stabilization to 0.63 mg at the end of the study. Forty percent experienced mild side effects, most commonly insomnia, nausea or dyspepsia, and dizziness. Only 5% experienced sleepiness, and none experienced sleep attacks while driving. Augmentation developed in 33%, most in the first year and all by 30 months. Augmentation was not predictable by prior augmentation with other dopaminergic agents. Only 1 patient discontinued pramipexole because of augmentation. CONCLUSIONS: Pramipexole was effective for RLS with continued response with time. Modest escalations in dose occurred, partly due to additional doses prescribed for augmentation. Side effects were common, but generally mild and tolerated. Sleepiness while driving was not a problem. Augmentation occurred in 33% of patients but was treatable with increased doses earlier in the day.

Adult↗

Sedation during mechanical ventilation: a systematic review.

OBJECTIVE: A systematic review was performed to determine the most effective agent with which to sedate adult patients who have respiratory failure that requires mechanical ventilation in the medical intensive care unit. DATA SOURCES: A computerized literature search of MEDLINE, a U.S. National Library of Medicine online database, from 1966 to August 1998 was conducted. All selected articles were reviewed to identify other relevant articles. STUDY SELECTION: Inclusion criteria were as follows: a) population-adults with respiratory failure who received mechanical ventilation in a medical intensive care unit; b) design-prospective, randomized controlled trial; c) intervention-sedation; and d) primary outcome-successful sedation. DATA EXTRACTION: Of 71 potentially relevant articles, only 15 randomized trials fulfilled all four selection criteria. DATA SYNTHESIS: Clinical heterogeneity among studies precluded statistical pooling of results. CONCLUSIONS: More research is needed to determine the most effective agent with which to sedate adult patients who have respiratory failure that requires mechanical ventilation in the medical intensive care unit.

Adult↗